Language Services:
The Why and the How
January 2015
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Objectives
When this course is complete, you should be
able to:
• Recognize the importance of providing
culturally and linguistically appropriate
services
• Explain the role of the patient and
companion in determining what services
are required for effective communication
• Identify the laws governing language services
• Explain how to access spoken language interpreter services at Inova
• Explain how to arrange for sign language interpreters and/or auxiliary aids at
Inova
ATTENTION!
• PLEASE NOTE: Use of related Epic work
flows will be taught separately at each OU or other entity
and to the appropriate staff under Epic training.
• Documentation of language services is imperative.
• Ensure you are familiar with your unit’s protocol for
documenting communication needs.
Office of Health Equity (OHE)
Vision:
• A community where all residents have access to resources that
promote and sustain health and well being.
Mission:
• To create a community where
• systemic and avoidable health disparities are steadily reduced,
so that the gap between the best and worst off is narrowed;
• all residents have equitable access to a full range of highquality healthcare and support;
• all have equal opportunities for optimal health and well being
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Office of Health Equity
Selected Office of Health Equity Programs and Services
•
•
Language Services
•
Spoken language interpretation
•
Sign language interpretation and the provision of other services for
the deaf or hard of hearing
•
Translation of vital documents
Training and Education
•
Diversity, Cultural Competence and Health Equity Education
•
21st Century Leadership Development Program
•
Now We’re Talking! Bi-lingual staff interpreter training
Patient Centered Care & Effective Communication
Effective communication supports patient centered, safe,
high quality care
• Effective communication requires that
information is understood by all parties
involved in care
AND
• Understood thoroughly enough that the
parties can use or act on information
exchanged
• Who determines what constitutes effective communication?
• The patient and companion determine this.
• We are not in a position to tell them what they need for effective
communication.--They must tell us.
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Patient Centered Care and Cultural Competence
• Patient centered care is by definition culturally
and linguistically appropriate
you
• It is deeply respectful of patient and family
you
values, beliefs and traditions
• This is true for all patients regardless of race,
ethnicity, age, gender, education, religion, socioeconomic status, language spoken, etc.
Experiences
Perceived Reality
The “truth”
The “truth”
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Interpreter Policy Summary
• Any patient and/or companion who is limited English
proficient or deaf or hard of hearing must be offered
interpreter services or auxiliary aids free of charge
• Interpreter services must be provided by trained,
qualified interpreters
• Friends and family may not be used as interpreters
unless specifically requested by the patient and
charted accordingly
• Minor children should never be used as interpreters
• In an extreme emergency, provide any necessary and appropriate medical
treatment and use your best efforts to provide the most effective communication
possible until the interpreter arrives
• Complete Policies (9-17-1 for Spoken Languages and 9-18-1 for Sign
Language) can be found on InovaNet.
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Language Services:
Spoken Language:
Your Responsibilities
Spoken Language
Title VI of the Civil Rights Act of 1964
No person in the United States shall, on the ground of race, color
or national origin, be excluded from participation in, be denied
the benefits of, or be subjected to discrimination under any
program or activity receiving Federal financial assistance.
• Language is considered a proxy for national origin.
• We must provide the same quality care regardless of language
spoken
• Patient’s language cannot be a barrier to equal access to Inova
services and programs.
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Spoken Language: Highlights of Title VI
• Trained medical interpreters must be provided to our Limited English
proficient patients at no cost to the patient
• Vital documents must be translated and communicated in the patient’s
language, including:
• application and enrollment forms
• letters or notices regarding eligibility or changes in benefits
• Information and education materials regarding patient’s medical
condition and services available
• anything requiring a response
• patient consent forms
• documents of a legal or financial nature
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Spoken Language Assessment
All Patients must be asked their language preference
•
The question to ask is: “In what language do
you prefer to talk with your doctors or nurses?”
•
Rely on what the patient or companion tells you
regarding his or her English language skills in
deciding whether an interpreter is needed
•
Document the patient’s language preference
in Epic under Demographics, including
• Refusal of service despite language
needs, and
• Emergency situations that require the
start of care before a trained interpreter
arrives
Secure Interpreter Services
If a patient or companion indicates a
Spanish language preference
Spanish Staff Interpreters
• Inova staff interpreters in Spanish are available
on all Inova hospital campuses
• A complete list with hours of coverage and
phone numbers can be found on InovaNet:
http://inovanet.net.inova.org/?id=1615&sid=1
• Call the appropriate extension to obtain a staff
interpreter at your location
Secure Interpreter Services
If patient or companion prefers a language other than English
Services are available at ALL Inova facilities in multiple
languages:
• Volunteer Interpreters who have completed 40-hour
medical interpreter training.
• Search “Language Bank” on InovaNet
• Over 600 volunteer interpreters in 45 languages
• Telephonic Interpretation (Interpreter phones)
• Available 24/7 in 170 languages
• For description of telephonic services, see
http://inovanet.net.inova.org/upload/docs/IHS%20Departments/OHE/2014%20Interp
reter%20Phone%20Deployment.pdf
Secure Interpreter Services
If patient or companion prefers a language other than English
Pre-scheduled on-site interpreter
services are available at ALL Inova
hospitals and in multiple languages
on a limited basis.
• To pre-schedule an on-site
interpreter, access the “Inova
Interpreter Request” on
InovaNet
• If the request requires an
immediate response, use the
Language Bank, the interpreter
phones or call the Scheduler at
703-776-7641 (Option 2)
Inova Interpreter Request
https://wlcapps.net.inova.org/langreq/LangRequest
/LangRequest.html
In-person Vendor Criteria
http://inovanet.net.inova.org/upload/docs/IHS%20D
epartments/OHE/Criteria%20-%202014-02-25.pdf
Services for
Deaf
or Hard of Hearing:
Your Responsibilities
Sign Language/Services for Deaf or Hard of Hearing
Title III of the Americans with Disabilities Act (ADA)
No individual may be discriminated against in the full and equal
enjoyment of goods, services, facilities, privileges and accommodations
in privately operated commercial facilities that are open to the public.
• ADA ensures equal access to goods and services for persons who are
deaf or hard of hearing
• ADA requires we provide effective communication and appropriate
auxiliary aids and services (including qualified interpreters) when
necessary to ensure effective communication for patients with disabilities
• We must identify and assist 100% of our patients and companions
who are deaf or hard of hearing
Communication Assessment
Working with the Deaf or Hard of Hearing
• Requests for service are guided by
the patient or companion
preferences
• Never try to dissuade a patient or
companion from requesting a specific
service or aid
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Communication Assessment
Deaf/HoH Patient and/or Companion Identifier
•
Any patient or companion who is deaf or hard of hearing must be
offered a visual identifier.
•
Use orange wrist bands for this purpose.
• Patient or companion is deaf: Use the band with the symbol
indicating deafness.
• Patient or companion is hard of hearing: Use the band that has
“HOH.”
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Communication Assessment
In a public area:
•
If you are approached by an individual who is deaf or hard of hearing in a public
area, help the patient or companion locate appropriate staff to assist in
obtaining services.
•
Examples of how you may help include:
• Accompany the patient or companion to an appropriate unit in the hospital
(for example, the assigned unit or registration)
• Locate clinical or registration staff, etc., who may be able to assist
• Locate a Video Remote Interpreting device (called InDemand) to help
communicate
• Exchange written notes , if appropriate, to answer immediate questions (for
example, to provide directions)
Rely on one another!
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Secure the Needed Resources
Video Remote Interpreting or VRI
• VRI, marketed as InDemand, may be used to provide Sign Language
interpreting either:
• For the entire visit when acceptable to the patient or companion, or
• Until a requested on-site interpreter arrives
• InDemand devices have been distributed to areas of greatest need for American
Sign Language (ASL).
• They are located at all Inova hospital EDs, L&D units, and most main
registration points, and are available through the Nurse Administrator to float
• They are also located at all HealthPlexes, ECCs, and UCCs
• See InovaNet for specific locations and key contacts
http://inovanet.net.inova.org/upload/docs/IHS%20Departments/OHE/InDemand
%20Contact%20List.100914.pdf
• Please note: While spoken language interpreting is available on InDemand, use
of these devices should be prioritized for the deaf and hard of hearing
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Secure the Needed Resources
Within 15 minutes of a patient or companion request for an
on-site interpreter:
• Call 703-776-7641 to obtain a Sign Language
Interpreter
– System-wide phone number
– Answered 24/7/365
– Use for scheduled and emergent needs
• Use VRI (InDemand) until the requested on-site
interpreter arrives
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Secure the Needed Resources
Requests for aids or VRI should be
addressed immediately:
These devices are available free of charge
•
Video Remote Interpreters (InDemand)
•
TTY’s
•
Pocketalkers and Poseys (sound amplifiers
best used for moderately hearing impaired people)
•
Written Materials
•
Telephone Handset Amplifiers
•
Telephones compatible with hearing aids
•
Virginia Relay Service -711
InDemand
TTY
Pocketalker
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Until the Interpreter Arrives
•
Use InDemand (Video Remote Interpreting) where available
• In EDs, L&Ds and for check-out from Nurse Administrator
• At Healthplexes, ECCs and UCCs
•
Communicate by writing notes
• Use multiple means of communicating
• Chart all notes exchanged
•
Do not rely on lip reading
• Unless the patient insists it is his/her preferred method of
communication
•
Document what you do!
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Documentation Requirements
• Document in Epic:
• All patient or companion requests for or refusals of service
• Your response to such requests for or refusals of service
• Any notes exchanged
• Types of services or auxiliary aids used
• Any unusual circumstances
If it isn’t documented, it didn’t happen.
Additional Information
INTERPRETER SERVICES